The prevalence of patients with H. pylori negative ulcer disease significantly decreased in our study population due to an increase in the number of patients with NSAID associated peptic ulcer disease. IPUD was rare and its prevalence did not increase over a period of 8 years.
Campylobacter species are frequently isolated from fecal specimens of patients with diarrheal illness. Several Campylobacter species are commonly isolated from the oral cavity. In contrast, Campylobacter species are rarely isolated from extra-oro-intestinal abscesses. Reported here are four cases of extra-oro-intestinal abscesses due to polymicrobial flora, including Campylobacter species. The first case is a 35-year-old woman who was diagnosed with a brain abscess caused by C. gracilis, Streptococcus constellatus, and anaerobic Gram-positive cocci. The second case is a 65-year-old man with a history of maxillary sinus carcinoma who developed a brain abscess due to polymicrobial flora, including C. concisus. The third case is a 24-year-old male who was diagnosed with a vertebral abscess caused by C. rectus, Eubacterium brachy, and Actinomyces species. The fourth case is a 74-year-old woman who presented with an intraorbital abscess due to C. showae and Micromonas (previously Peptostreptococcus) micros. The first two patients died from a cause directly related to their abscesses. All Campylobacter species involved in the four cases were isolated anaerobically. The isolation of oral Campylobacter species, e.g., C. rectus and C. showae, from abscesses suggests an oral source. A survey of the English literature was undertaken to identify reports of Campylobacter species isolated from extra-oro-intestinal abscesses.
Multiple strain infection is common. H. pylori strains possessing the vacA s1 genotype and/or cagA are associated with PUD. GERD patients, infected with H. pylori, mostly carry less virulent strains possessing neither cagA nor iceA1. Our findings support the hypothesis that virulent strains protect against the development of GERD.
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